Provider Demographics
NPI:1598363079
Name:PETERS, ZACHARY ALLEN (DC)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:ALLEN
Last Name:PETERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2071 ANTIOCH CT STE 203
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-2955
Mailing Address - Country:US
Mailing Address - Phone:408-313-2042
Mailing Address - Fax:
Practice Address - Street 1:2071 ANTIOCH CT STE 203
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-2955
Practice Address - Country:US
Practice Address - Phone:408-313-2042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34629111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor